fresh pair of eyes needed please.

Hi my ds is 15 weeks old and is breastfed on demand with a 2oz and 1oz top up which is supplemented at the right breast. The reason for supplement is because he had weight loss after birth 8% of birth weight and at 3 weeks he had not gained any weight and still hoad some jaundice. So I was told by everyone (including lactation consultant and pediatrician) to top him up. I was very reluctant and would only give him a small amount of supplement as I did not want ds to prefer syringe feeding to breast ( started supplementing at breast from 7 weeks).

My ds did not like my right breast, was given the advice to just feed on one side and there is a lot less on this side and slow let down. I managed to reduce top up to 3oz in 24 hours from 5oz but now I can't seem to be able to reduce the amount further. I think I am scared and if I reduce the amount to just 2oz ds is irritable the next day. Also if I try and drop the 2oz to 1oz ds crys for more and will not latch on left side with good supply.

Feel like I have had an increase on the left side in the last few days, was ill for 8 weeks and feel this hindered my milk supply.my ds weigh gain is as follows:
Birth: 7lb 5 oz
4-20 days 6lb 11oz
27 days 6lb 15oz
4 weeks 7lb 1oz
6weeks 7lb 13oz
8 weeks 8lb 10oz
9 weeks 9lb 4oz
11 weeks 9lb 14oz
14 weeks 10lb 10oz

My ds feeds roughly every hour in day and every 2 at night, have to wake him as he would sleep straight through if I let him. Ds has been sleepy from the start.

If I can boost my right side (low supply) then I should be able to exclusively breastfeed and ds should continue to gain weight.
Any help or advice to help me achieve this would be fantastic.

Re: fresh pair of eyes needed please.

So you are supplementing 3 ounces total, per 24 hours? 3 ounces-of expressed milk? or of formula? Is this done in small increments after several feedings or in one bottle or what?
And how long has this been all you have needed to supplement?

Re: fresh pair of eyes needed please.

Originally Posted by @llli*lllmeg

So you are supplementing 3 ounces total, per 24 hours? 3 ounces-of expressed milk? or of formula? Is this done in small increments after several feedings or in one bottle or what?
And how long has this been all you have needed to supplement?

Hi thanks for the reply. Yes 3oz total of formula in 24 hours, for the last 4 weeks (did not reduce further due to illness). I am supplementing using a lactation aid and is given in the afternoon/ evening after feeding on good left side and as much as ds will feed on right side.

Re: fresh pair of eyes needed please.

So 3 ounces is only about 10% of the average daily intake of a breastfed baby a month old or older of approximately 30 ounces...I think 3 ounces more or less would easily be within normal daily intake fluctuation. So I cannot imagine not getting this would make a baby more fussy the next day...

So if weight gain were clearly good, I would say, probably fine to back off this supplementation if you like, and simply offer to nurse baby more often if baby is fussy.

But what is the weekly gain, on average, during about the same time...11 weeks to 14 weeks-three weeks-with a gain of 12 ounces...so about 4 ounces a week? Not horrible, but really not a fantastic gain either. And is a slight dropoff from the average of 5 ounces per week for the previous two weeks. This could be explained by your illness at least in part, so maybe just keep going as you are for a couple more weeks and see where you are?

Are you working with an IBCLC? What does your doctor think of baby’s growth and overall health?

Baby is almost 4 months old, so rate (velocity) of gain would actually start normally slowing anyway, so keep that in mind as well.

Re: fresh pair of eyes needed please.

Thank you so much for the information. I am in the UK so I have been working with my health visitor and have been signed off from the pediatrician. They are both happy as long as my ds continues to gain weight and follow his curve on the growth chart. I am waiting to hear back from a lactation consultant, just wanted to get as many opinions as possible. The most important thing to me is for my baby to gain weight and be happy and healthy. I will keep going for a few more weeks and then review the situation. Do you think it is worth while taking fenugreek and pumping to see if I can supplement with breast milk instead of formula?

Re: fresh pair of eyes needed please.

Well, the basics of increasing milk production are that the more frequently milk is removed, the more milk the body makes. So anytime there is low production and especially if baby is being supplemented, pumping is typically something to seriously consider.
But I think the first step would probably be to make sure baby is nursing a much as baby will. There is certainly no harm in offering to nurse more often.

If you also pump, keep sessions short and manageable, about 15 minutes per side to start and adjust as needed. Do not worry about the amount of milk that comes out when you pump. That is vital. The volume of milk removal via pumping it is not a reliable indicator of anything, so don't get sent off track worrying about that. Whatever you pump, give to your baby, and if you still need to give baby a little formula, that is ok. Also make sure you have a good pump!

If you want to add a galactagogue as well, they certainly have helped many moms. Fenugreek is a popular one but it is not the only one. Some mothers find blends of two or more herbs more helpful. I would suggest discussing this with your IBCLC. If you know WHY you have had low milk production that may help indicate which type of galactagogue will likely be more helpful.

A very good book on this subject, very readable and written for moms, is Making More Milk.www.kellymom.com also has good articels on low production in general and galactagogues.